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7428 SKIPLEY RD LINE 5 2016-01-01 MF Import
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SKIPLEY RD
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7428
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LINE 5
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7428 SKIPLEY RD LINE 5 2016-01-01 MF Import
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Last modified
3/29/2017 9:13:47 AM
Creation date
3/29/2017 9:08:33 AM
Metadata
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Template:
Address Document
Street Name
SKIPLEY RD
Street Number
7428
Tenant Name
LINE 5
Imported From Microfiche
Yes
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. � - i <br /> PRY..AGBEEl1�NT <br /> The underaiQned hereby reQuasts the City of Everett to waive <br /> the PAV charge on his/her water service at <br /> I U <br /> , �/PG���..,1�UG/'�G�/2, The undersigned <br /> _�G'�`1�2 ,vd s7'- SEJ <br /> represent that the sefvice at said location preaently has a PRV <br /> in Qood WorkinQ order and that, in oonsideration of r+aiver of <br /> said charQe, Por the period that undersigned is a water service <br /> cuatomer at the above location, the undarsigned agreas: <br /> 1 . To maintain said PRV in good working order; and <br /> ?., To releaae the City of Everett Prom any nnd all <br /> liability arising from increased opeiating pressures on <br /> the p5 transmission line to which the above uater <br /> . service ia connected; and <br /> I ' 3. To indemniPy end hold harmleaa the City of Everett from <br /> any and all claims related to the failure of the PRV <br /> I Snatalled at the above location. This indemnity is on <br /> behalf of the undersigned, and the undersigned aerees <br /> to notiPy the city of Everett oP any change of <br /> I oxnerahip of the watar aervice connection at the above <br /> location. <br /> � DATED this ?—S day o! �.� �m �': 1987. <br /> I S� <br /> . _ <br /> STATTs Or k'ASHIN(3TON) <br /> ss: <br /> COUNTY OF�°^��� ) <br /> I certily that I know or have satisfactory evidence <br /> that M�'-hac L l�. �►�s� �1�f�R L•�N�'n.cs siened this <br /> ; � <br /> � instrument and acknowledged it to be (his, her, their) free <br /> � <br /> and voluntary act for the uses and purposes mention in the <br /> jinstrument. <br /> Inetea: � ols=g � ----- <br /> I (Seal or Stamp( Signature oI <br /> Notary Public:� ����' <br /> Title: _ <br /> IMY commission exp�res: �L'-_/S"-�9_ <br /> � , <br /> � <br /> i . <br /> I <br /> � <br /> i ,� <br /> � <br />
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